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WO2000015293A1 - Stimulation combinee des racines sacree ventrale et dorsale destinee a reguler la fonction vesicale - Google Patents

Stimulation combinee des racines sacree ventrale et dorsale destinee a reguler la fonction vesicale Download PDF

Info

Publication number
WO2000015293A1
WO2000015293A1 PCT/US1999/021049 US9921049W WO0015293A1 WO 2000015293 A1 WO2000015293 A1 WO 2000015293A1 US 9921049 W US9921049 W US 9921049W WO 0015293 A1 WO0015293 A1 WO 0015293A1
Authority
WO
WIPO (PCT)
Prior art keywords
electrode
bladder
ventral
sacral
dorsal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1999/021049
Other languages
English (en)
Inventor
Narendra Bhadra
J. Thomas Mortimer
Volker Grunewald
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Axon Engineering Inc
Original Assignee
Axon Engineering Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Axon Engineering Inc filed Critical Axon Engineering Inc
Priority to AU63885/99A priority Critical patent/AU758611B2/en
Priority to EP99951446A priority patent/EP1113841A1/fr
Priority to US09/787,244 priority patent/US7142925B1/en
Priority to CA002343928A priority patent/CA2343928A1/fr
Publication of WO2000015293A1 publication Critical patent/WO2000015293A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control

Definitions

  • This invention relates generally to selective nerve stimulation for bladder
  • urinary calculi remains a major factor leading to morbidity in spinal cord injured
  • urethral or anal sphincter allows the development of techniques to selectively
  • the motor impulse is
  • sacral nerves are separated to isolate the ventral and dorsal roots thereof, and the
  • inferior somatic nerve SI is sectioned to isolate the external sphincter on one side.
  • the dorsal root of S2 is then sectioned unilaterally to isolate the sensory function
  • An electrode is positioned on the S3 sacral nerve to stimulate the detrusor
  • sphincter response may be
  • the present invention contemplates a new technique for bladder function
  • sacral motor roots and also the sacral sensory roots.
  • FIG. 1 schematically illustrates the placement of electrodes for controlling the
  • FIG. 2 is a graphic representation showing average voided volume from
  • FIG. 3 is a graphic representation showing average voided volume when
  • FIG. 4 illustrates a stimulation scheme which may be used for combined
  • FIG. 1 there is shown an illustrative embodiment of the
  • Kidney 10 is
  • Urine is expelled from the body through bladder neck 16 and
  • urethra 18 and out from urethral sphincter 20.
  • Bladder 12 and sphincter 20 function
  • Dorsal roots 23 are primarily sensory (afferent) to transmit sensation to spinal cord 19, while ventral roots 22
  • Ventral roots 22 include nerve bundles 22a which include larger diameter
  • nerve fibers and nerve bundles 22b which include smaller diameter fibers. Larger
  • fibers 22a connect between spinal cord 19 and sphincter 20, while smaller fibers 22b
  • Smaller fibers 22b usually carry no action potentials until the person desires
  • a cuff electrode 30 can be
  • Cuff electrode 30 which is preferably a self-curling spiral electrode that is biased to curl around the selected root and is described in U.S. Patent No. 4,602,624, is configured to accommodate nerves of
  • the present invention also includes an additional cuff electrode 32 which is
  • roots can result in the voiding of bladder contents without increasing sphincter
  • a controller 34 is electrically coupled to electrodes 30 and 32 to provide
  • nerve cuff electrode implanted on S2 motor roots. Either a quasitrapezoidal, balanced biphasic, 20 Hz pulse, with current amplitude set at a volume determined
  • the efferent sensory stimulus was applied to the S2 dermatome
  • the surface stimulus was varied to be continuous or intermittent (1 second
  • FIG. 2 shows the average volume of fluid voided during a 10 second pulse
  • halothane inhalation anesthesia The motor stimulus was applied by a spiral nerve
  • the sensory stimulus was applied to SI, S2, or
  • the intermittent surface stimulation was varied to be either 1
  • Table 1 shows the average results from three trials for each stimulus pattern.
  • FIG. 3 shows the
  • V(ml) Average voided volume in ml
  • FIG. 4 illustrates the stimulus pattern for the combined dorsal and ventral
  • An intermittent pulse train 100 is applied
  • pressure bladder activation can be achieved by modulating the reflexes associated
  • Pulse train 100 preferably consists of pulses delivered at a frequency of 10 to
  • each pulse having a nominal amplitude of less than 1 ma and a pulse
  • Pulse train 100 is generated intermittently, with a
  • Pulse train 102 preferably

Landscapes

  • Health & Medical Sciences (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Electrotherapy Devices (AREA)

Abstract

L'invention concerne un appareil et une technique servant à réguler la fonction vésicale d'un patient par la stimulation combinée des racines sacrées ventrale et dorsale. Une électrode est implantée dans les nerfs sacrés moteurs, et une deuxième électrode est implantée dans les nerfs sacrés sensoriels. On stimule ces nerfs en utilisant des trains d'impulsions quasi-trapézoïdales pour activer et vider la vessie de manière sélective. Cette technique rend superflue l'opération de rhizotomie dorsale.
PCT/US1999/021049 1998-09-16 1999-09-14 Stimulation combinee des racines sacree ventrale et dorsale destinee a reguler la fonction vesicale Ceased WO2000015293A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
AU63885/99A AU758611B2 (en) 1998-09-16 1999-09-14 Combined stimulation of ventral and dorsal sacral roots for control of bladder function
EP99951446A EP1113841A1 (fr) 1998-09-16 1999-09-14 Stimulation combinee des racines sacrees ventrales et dorsales, destinee a reguler la fonction vesicale
US09/787,244 US7142925B1 (en) 1998-09-16 1999-09-14 Combined stimulation of ventral and dorsal sacral roots for control of bladder function
CA002343928A CA2343928A1 (fr) 1998-09-16 1999-09-14 Stimulation combinee des racines sacree ventrale et dorsale destinee a reguler la fonction vesicale

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10054298P 1998-09-16 1998-09-16
US60/100,542 1998-09-16

Publications (1)

Publication Number Publication Date
WO2000015293A1 true WO2000015293A1 (fr) 2000-03-23

Family

ID=22280289

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1999/021049 Ceased WO2000015293A1 (fr) 1998-09-16 1999-09-14 Stimulation combinee des racines sacree ventrale et dorsale destinee a reguler la fonction vesicale

Country Status (4)

Country Link
EP (1) EP1113841A1 (fr)
AU (1) AU758611B2 (fr)
CA (1) CA2343928A1 (fr)
WO (1) WO2000015293A1 (fr)

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001089629A1 (fr) * 2000-05-26 2001-11-29 Consejo Superior De Investigaciones Científicas Systeme de stimulation des racines sacrales moyennant un implant a alimentation radioelectrique
WO2001060445A3 (fr) * 2000-02-17 2002-04-18 Neurodan As Procedes et systemes implantables de detection neuronale et de stimulation nerveuse
WO2010069317A1 (fr) * 2008-12-19 2010-06-24 Neurodan A/S Salves d'impulsions électriques utilisées pour traiter les affections pelviennes par électrostimulation des nerfs
US7813803B2 (en) 2005-06-09 2010-10-12 Medtronic, Inc. Regional therapies for treatment of pain
US7890176B2 (en) 1998-07-06 2011-02-15 Boston Scientific Neuromodulation Corporation Methods and systems for treating chronic pelvic pain
US9452287B2 (en) 2013-01-21 2016-09-27 Cala Health, Inc. Devices and methods for controlling tremor
US9802041B2 (en) 2014-06-02 2017-10-31 Cala Health, Inc. Systems for peripheral nerve stimulation to treat tremor
US10765856B2 (en) 2015-06-10 2020-09-08 Cala Health, Inc. Systems and methods for peripheral nerve stimulation to treat tremor with detachable therapy and monitoring units
US10814130B2 (en) 2016-07-08 2020-10-27 Cala Health, Inc. Dry electrodes for transcutaneous nerve stimulation
US11331480B2 (en) 2017-04-03 2022-05-17 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation for treating diseases related to overactive bladder
US11344722B2 (en) 2016-01-21 2022-05-31 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation for treating diseases related to overactive bladder
US11596785B2 (en) 2015-09-23 2023-03-07 Cala Health, Inc. Systems and methods for peripheral nerve stimulation in the finger or hand to treat hand tremors
US11857778B2 (en) 2018-01-17 2024-01-02 Cala Health, Inc. Systems and methods for treating inflammatory bowel disease through peripheral nerve stimulation
US11890468B1 (en) 2019-10-03 2024-02-06 Cala Health, Inc. Neurostimulation systems with event pattern detection and classification
US12233265B2 (en) 2016-08-25 2025-02-25 Cala Health, Inc. Systems and methods for treating cardiac dysfunction through peripheral nerve stimulation
US12251560B1 (en) 2019-08-13 2025-03-18 Cala Health, Inc. Connection quality determination for wearable neurostimulation systems
US12453853B2 (en) 2013-01-21 2025-10-28 Cala Health, Inc. Multi-modal stimulation for treating tremor

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3870051A (en) * 1972-04-27 1975-03-11 Nat Res Dev Urinary control
US4569351A (en) * 1984-12-20 1986-02-11 University Of Health Sciences/The Chicago Medical School Apparatus and method for stimulating micturition and certain muscles in paraplegic mammals
US4602624A (en) 1984-10-11 1986-07-29 Case Western Reserve University Implantable cuff, method of manufacture, and method of installation
US4607639A (en) 1984-05-18 1986-08-26 Regents Of The University Of California Method and system for controlling bladder evacuation
US4608985A (en) 1984-10-11 1986-09-02 Case Western Reserve University Antidromic pulse generating wave form for collision blocking
EP0245547A1 (fr) * 1986-05-12 1987-11-19 The Regents Of The University Of California Système électronique pour la neurostimulation des viscères pelviens
US5199430A (en) 1991-03-11 1993-04-06 Case Western Reserve University Micturitional assist device
US5370670A (en) * 1993-12-13 1994-12-06 Thomas Jefferson University Detrusor myoplasty and neuromuscular electrical stimulation of the urinary bladder

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3870051A (en) * 1972-04-27 1975-03-11 Nat Res Dev Urinary control
US4607639A (en) 1984-05-18 1986-08-26 Regents Of The University Of California Method and system for controlling bladder evacuation
US4602624A (en) 1984-10-11 1986-07-29 Case Western Reserve University Implantable cuff, method of manufacture, and method of installation
US4608985A (en) 1984-10-11 1986-09-02 Case Western Reserve University Antidromic pulse generating wave form for collision blocking
US4569351A (en) * 1984-12-20 1986-02-11 University Of Health Sciences/The Chicago Medical School Apparatus and method for stimulating micturition and certain muscles in paraplegic mammals
EP0245547A1 (fr) * 1986-05-12 1987-11-19 The Regents Of The University Of California Système électronique pour la neurostimulation des viscères pelviens
US5199430A (en) 1991-03-11 1993-04-06 Case Western Reserve University Micturitional assist device
US5370670A (en) * 1993-12-13 1994-12-06 Thomas Jefferson University Detrusor myoplasty and neuromuscular electrical stimulation of the urinary bladder

Cited By (38)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7890176B2 (en) 1998-07-06 2011-02-15 Boston Scientific Neuromodulation Corporation Methods and systems for treating chronic pelvic pain
WO2001060445A3 (fr) * 2000-02-17 2002-04-18 Neurodan As Procedes et systemes implantables de detection neuronale et de stimulation nerveuse
US7403821B2 (en) 2000-02-17 2008-07-22 Neurodan A/S Method and implantable systems for neural sensing and nerve stimulation
US7996089B2 (en) 2000-02-17 2011-08-09 Neurodan A/S Methods and implantable systems for neural sensing and nerve stimulation
ES2164017A2 (es) * 2000-05-26 2002-02-01 Consejo Superior Investigacion Sistema de estimulacion de raices sacras mediante implante alimentado por radio frecuencia.
ES2164017B1 (es) * 2000-05-26 2004-06-01 Consejo Superior De Investigaciones Cientificas Sistema de estimulacion de raices sacras mediante implante alimentado por radio frecuencia.
WO2001089629A1 (fr) * 2000-05-26 2001-11-29 Consejo Superior De Investigaciones Científicas Systeme de stimulation des racines sacrales moyennant un implant a alimentation radioelectrique
US7813803B2 (en) 2005-06-09 2010-10-12 Medtronic, Inc. Regional therapies for treatment of pain
US8244360B2 (en) 2005-06-09 2012-08-14 Medtronic, Inc. Regional therapies for treatment of pain
US7890166B2 (en) 2005-06-09 2011-02-15 Medtronic, Inc. Regional therapies for treatment of pain
WO2010069317A1 (fr) * 2008-12-19 2010-06-24 Neurodan A/S Salves d'impulsions électriques utilisées pour traiter les affections pelviennes par électrostimulation des nerfs
US10625074B2 (en) 2013-01-21 2020-04-21 Cala Health, Inc. Devices and methods for controlling tremor
US12161858B2 (en) 2013-01-21 2024-12-10 Cala Health, Inc. Devices and methods for controlling tremor
US9452287B2 (en) 2013-01-21 2016-09-27 Cala Health, Inc. Devices and methods for controlling tremor
US10850090B2 (en) 2013-01-21 2020-12-01 Cala Health, Inc. Devices and methods for controlling tremor
US12453853B2 (en) 2013-01-21 2025-10-28 Cala Health, Inc. Multi-modal stimulation for treating tremor
US9802041B2 (en) 2014-06-02 2017-10-31 Cala Health, Inc. Systems for peripheral nerve stimulation to treat tremor
US10561839B2 (en) 2014-06-02 2020-02-18 Cala Health, Inc. Systems for peripheral nerve stimulation
US10549093B2 (en) 2014-06-02 2020-02-04 Cala Health, Inc. Method for peripheral nerve stimulation
US10179238B2 (en) 2014-06-02 2019-01-15 Cala Health, Inc. Systems for peripheral nerve stimulation
US10173060B2 (en) 2014-06-02 2019-01-08 Cala Health, Inc. Methods for peripheral nerve stimulation
US10905879B2 (en) 2014-06-02 2021-02-02 Cala Health, Inc. Methods for peripheral nerve stimulation
US10960207B2 (en) 2014-06-02 2021-03-30 Cala Health, Inc. Systems for peripheral nerve stimulation
US12109413B2 (en) 2014-06-02 2024-10-08 Cala Health, Inc. Systems and methods for peripheral nerve stimulation to treat tremor
US10765856B2 (en) 2015-06-10 2020-09-08 Cala Health, Inc. Systems and methods for peripheral nerve stimulation to treat tremor with detachable therapy and monitoring units
US12157001B2 (en) 2015-06-10 2024-12-03 Cala Health, Inc. Systems and methods for peripheral nerve stimulation to treat tremor with detachable therapy and monitoring units
US12420082B2 (en) 2015-09-23 2025-09-23 Cala Health, Inc. Systems and methods for peripheral nerve stimulation in the finger or hand
US11596785B2 (en) 2015-09-23 2023-03-07 Cala Health, Inc. Systems and methods for peripheral nerve stimulation in the finger or hand to treat hand tremors
US11918806B2 (en) 2016-01-21 2024-03-05 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation of the leg
US11344722B2 (en) 2016-01-21 2022-05-31 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation for treating diseases related to overactive bladder
US12357824B2 (en) 2016-01-21 2025-07-15 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation
US10814130B2 (en) 2016-07-08 2020-10-27 Cala Health, Inc. Dry electrodes for transcutaneous nerve stimulation
US12233265B2 (en) 2016-08-25 2025-02-25 Cala Health, Inc. Systems and methods for treating cardiac dysfunction through peripheral nerve stimulation
US12161865B2 (en) 2017-04-03 2024-12-10 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation
US11331480B2 (en) 2017-04-03 2022-05-17 Cala Health, Inc. Systems, methods and devices for peripheral neuromodulation for treating diseases related to overactive bladder
US11857778B2 (en) 2018-01-17 2024-01-02 Cala Health, Inc. Systems and methods for treating inflammatory bowel disease through peripheral nerve stimulation
US12251560B1 (en) 2019-08-13 2025-03-18 Cala Health, Inc. Connection quality determination for wearable neurostimulation systems
US11890468B1 (en) 2019-10-03 2024-02-06 Cala Health, Inc. Neurostimulation systems with event pattern detection and classification

Also Published As

Publication number Publication date
EP1113841A1 (fr) 2001-07-11
CA2343928A1 (fr) 2000-03-23
AU6388599A (en) 2000-04-03
AU758611B2 (en) 2003-03-27

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